Plastic Surgery

Advances in liposuction create safer, more effective body-contouring options

Plastic Surgery

Plastic surgery before and after liposuction
Liposuction has been the most popular cosmetic surgery procedure in the U.S. in recent years, but it should not be used as a weight-loss strategy. Patients should expect to lose inches, not pounds.

Remember the first few weeks of the pandemic, when Americans jumped on the Netflix-bingeing, snack-chomping bandwagon to cope with the quarantine? We all indulged, assuming life – and healthy, active lifestyles – would snap back to normal soon.

But those weeks turned into months, and for many, less-healthy habits became part of everyday life. That led to weight gain, which led to stubborn fat deposits that even the most rigorous post-pandemic diet and exercise efforts couldn't melt.

Dealing with unwanted love handles and stubborn fat around your thighs can be very frustrating, particularly when you’ve put in the work to get your health back on track. So, it’s no surprise people are searching for a little boost from liposuction, the most-performed cosmetic surgery in 2021-22, according to The Aesthetic Society.

Despite its popularity, there are a lot of misperceptions about what liposuction can and can’t do and who can benefit from the procedure.

Let us be clear: Liposuction is not a weight-loss strategy. In fact, getting liposuction when you still have weight to lose is a sure path to needing more extensive work done down the line. But for patients who are maintaining a healthy lifestyle, liposuction can serve as the finishing touch to achieve the look they desire. Incredible advancements in liposuction over the past decade have improved our ability to help patients rejuvenate their appearance, from head to toe.

The board-certified plastic surgeons at UT Southwestern’s Department of Plastic Surgery are recognized leaders in reconstructive and cosmetic procedures. We are also intimately involved in setting safety and efficacy guidelines used around the world. We’ve gathered a few of the top questions we get about liposuction, and it's our hope that the answers can help clear up any confusion or misconceptions you might have about it.

How does liposuction work?

Bardia Amirlak, M.D., FACS: Liposuction is not just suctioning the fat away. It is removing a layer of fat between the skin and muscle tissue and shaping and contouring what is left behind. This is why it’s important to see a board-certified plastic surgeon for liposuction. We have the holistic training to appropriately remove fat and address the empty space to create a fresh look without a sagging or hollow appearance.

Traditional liposuction involves infusing the target area with a saline solution and medication to reduce pain and bleeding. The surgeon inserts a thin tube called a cannula into the fat and suctions it away with an attached vacuum device.

UT Southwestern offers advanced techniques, including:

  • Ultrasound assisted: Sound wave energy delivered to targeted areas helps break the walls of fat cells, which are then suctioned away.
  • Traditional or suction assisted: Mechanical disruptions and suction are used with a vacuumlike cannula to remove fat.
  • Power assisted: Using special cannulas that cycle 4,000 times per minute to break up fat, surgeons remove fat cells more efficiently, which leads to shorter, safer surgeries.
  • Laser assisted: Laser energy is absorbed by the fat cells, liquifying the fat before it is suctioned out, causing less trauma to surrounding tissues and contributing to a quicker recovery. The laser is also used to tighten the skin.

Christine Carman Stiles, M.D.: For most patients, liposuction is not the primary procedure – it’s part of a body-contouring plan that considers the overall look a patient wants to achieve rather than focusing on a single area. For example, during a tummy tuck, we will use liposuction to contour the flanks, accentuate the waist, and define the muscles of the abdomen. As part of facial rejuvenation, fat is harvested from unwanted areas of the body and injected into aging areas of the face – cheeks, nasolabial folds, and lips, for example, to give the face a more youthful appearance and improve body contours.

UTSW before-and-after photos

Is liposuction safe?

Dr. Amirlak: Funny you should ask! Liposuction as part of a body-contouring plan follows steps that spell out "SAFE":

  • Separation: Creating space between the fat cells and surrounding muscle and skin.
  • Aspiration: Suctioning away unwanted fat from the problem area.
  • Fat Equalization: Shaping and redistributing remaining fat cells to create a holistic, smooth look.

UT Southwestern has set the standard for SAFE body contouring, and we helped develop new national safety guidelines for sculpting procedures such as the “Brazilian butt lift.”

Dr. Stiles: Liposuction is one of the safest plastic surgery procedures available. The risk of minor complications is less than 0.2%, and the risk of major complications is about 1 in 50,000 patients. Your plastic surgeon will discuss with you the risks associated with liposuction, which can include:

  • Unsatisfactory contour
  • Anesthesia complications
  • Bleeding
  • Blood clots
  • Infection
  • Nerve or tissue damage
  • Fluid buildup (edema)
  • Contour irregularities

Patients who want liposuction should seek treatment only from board-certified plastic surgeons. The risks increase significantly in the hands of a doctor or spa professional who may not have the appropriate training and experience in plastic surgery.

Can liposuction help me lose weight?

Dr. Stiles: Liposuction should not be used as a weight-loss strategy. Patients should expect to lose inches, not pounds.

Some patients may benefit from liposuction of the neck to remove a double chin and define the jawline. The Necklaze procedure uses laser-assisted liposuction to contour and rejuvenate the neck in a short outpatient procedure.

Dr. Amirlak: For most patients, liposuction is probably the last procedure you’d want after losing weight with popular GLP1-RA medications such as semaglutide or tirzepatide (better known by brand names such as Wegovy, Ozempic, and Mounjaro). Fat loss can happen rapidly with weight-loss medications, resulting in gaps between the skin and muscle that appear as sagging or hollow skin, which social media has dubbed Ozempic face.

After you’ve maximized your weight loss and feel as if you can comfortably maintain a body mass index (BMI) of less than 32 through diet and exercise, you might consider liposuction as part of a body-contouring procedure to remove stubborn fat from areas such as the upper back, love handles, lower abdomen, or thighs.

Related reading: Look and feel young again with nonsurgical facial rejuvenation

What are some of the most recent techniques?

Dr. Amirlak: One of the biggest changes in the last decade has been the advent of “360 liposuction,” which focuses not just on one trouble area – like the lower abdomen – but all around the trunk, including the upper back, love handles, and flanks.

We study the patient’s underlying musculature and fascia bands to make a plan for removing fat only in places that should be hollow or lean and plumping areas that should be fuller, such as the cheeks and under the eyes, for a more youthful appearance.

This personalized approach gives patients options based on their body type. For example, an athletic woman might want to remove stubborn abdominal fat to reveal her abs, whereas an athletic man might prefer fat redistribution to sculpt the chest and avoid potential complications with pectoralis implants.

Dr. Stiles: We’ve also enhanced the traditional face and neck lift with a personalized combination of procedures to raise, tighten, and reshape the facial skin and fat to reduce wrinkles and create a natural, smooth appearance. Since volume in the face contributes to a more youthful look, an important part of the rejuvenation process often includes transferring fat to the face.

Related reading: Ready for your video closeup? Simple ways to look and feel confident

If you have stubborn fat deposits that won’t budge despite your best efforts with diet and exercise, talk with a board-certified plastic surgeon about whether body contouring with liposuction might be a good fit for you.

To discuss your body contouring options, call 214-645-8300 or request an appointment online.